ENT

Question 1

Presbycusis (age related hearing loss) Fx

Answer 1

bilateral high frequency hearing loss

Question 2

Acoustic neuroma Fx

Answer 2

unilateral hearing loss, vertigo, nausea

Question 3

Acoustic neuroma Ix

Answer 3

MRI Head
auditory brainstem response testing

Question 4

Cholesteatoma Fx

Answer 4

unilateral hearing loss
otoscopy - pearly white lump in attic of tympanic membrane
Conductive hearing loss

Question 5

Osteoma Fx

Answer 5

rare
unilateral ear pain followed by unilateral hearing loss
common in cold water swimmers

Question 6

Epistaxis Mx

Answer 6

1st - first aid 20minutes - squeeze nostrils
2nd - topical adrenaline/local anaesthetic/ topical tranexamic acid
3. nasal packing .
4. surgical intervention (sphenopalatine artery ligation).

Question 7

Otitis externa Mx

Answer 7

1st - topical antibiotic + topical steroid
2nd - PO Abx + Antifungal + ENT

Question 8

Malignant otitis externa
Fx
Ix

Answer 8

immunocompromised patient (esp diabetes)
commonly pseudomonas aeruginosa
Ix - CT scan

Question 9

malignant otits externa Mx

Answer 9

IV Abx (Ciprofloxacin)
ENT urgent

Question 10

malignant otits externa Mx

Answer 10

IV Abx (Ciprofloxacin)
ENT urgent

Question 11

Otosclerosis Fx

Answer 11

autosomal dominant
20-40 yr olds
tinnitus and conductive hearing loss

Question 12

Meniere’s Fx

Answer 12

vertigo
tinnitus
sensorineural hearing loss

Question 13

Perforated tympanic membrane (ear drum) Mx

Answer 13

majority self resolve within 6-8 weeks
give Abx if associated otitis media
ENT referral if not healed by 6 weeks for myringoplasty

Question 14

2 week wait for ENT/ oral Ca indications (6)

Answer 14

• oral ulcer >3 weeks
• red/ white patches that bleed/ painful
• earache (+head/neck pain) > 4weeks with normal otoscopy
• neck lump changed over 3 weeks
• persistent sore or painful throat
• oral cavity >6 weeks

Question 15

tonsillitis Mx

Answer 15

phenoxymethylpennicillin
erythromycin (if pen allergy)

Question 16

conductive hearing loss Rinne and weber explained

Answer 16

1st - if bone > air = conductive hearing loss
2nd - webers will be heard loudest on the same side of the bone>air ear = conductive

Question 17

conductive hearing loss causes

Answer 17

Impacted wax
Inner ear effusion
Debris/foreign body in ear canal
Perforated ear drum
Otosclerosis

Question 18

sensorineural hearing loss rinne and weber explained

Answer 18

1st - rinne air > bone ALWAYS
2nd - weber is heard loudest on OPPOSITE ear (eg if left is loudest, therefore right ear sensorineural loss)

Question 19

menierres Mx

Answer 19

ENT referral OP
contact dvla - stop driving until symptoms under control
acute attack - buccal/ IM prochlorperazine
prevention - betahistine/ vestibular rehab

Question 20

red flag symptoms of chronic rhinosinusitis (3)

Answer 20

unilateral
persistent despite 3 months of treatment
epistaxis

Question 21

chronic rhinosinusitis Mx

Answer 21

intranasal steroid
nasal irrigation with saline

Question 22

2 week wait laryngeal Ca

Answer 22

> 45 yo
persistent hoarse throat
neck lump
sore throat >4 week

Question 23

BPPV
Ix
Mx

Answer 23

Ix - Dix Hallpike
Mx - epley

Question 24

Bullous myringitis Fx

Answer 24

painful vesicles on tympanic membrane

Question 25

Unilateral nasal obstruction
Unilatwr epistaxis without trauma
? Cause

Answer 25

Nasopharyngeal ca